Karen Franklin Ph.D.

“Pornography Addiction:” Science or Naked Rhetoric?

Debate growing over pornography's role in life problems

No one really knows what percentage of Internet use is sexually oriented, or how much money the porn industry is making. Many commonly cited figures are widely exaggerated, and the true figures remain murky and highly contested. Yet it's safe to say that for some portion of the public, the easy accessibility leads to habitual use that interferes with other activities, such as family life, relationships, work or school.

No worries. Treatment providers are standing by to help. A quick Google search produces dozens of residential treatment programs for pornography addicts.

What's not so easy to find is the price tag. The sites I surveyed require that you call them, or submit an online application for more information. That reticence is not surprising, given that costs average about $675 per day, or more than $180,000 for the nine-month minimum stay that some programs recommend.

This burgeoning pornography addiction industry is the latest example of the therapeutic opportunism that has swept across the United States, selling snake oil remedies for alcoholism, drug addiction, overeating, adolescent rebellion, and so many more problems of modern living.

Unbeknownst to a gullible and desperate public, this new treatment industry is largely unregulated, and its grand claims have scant scientific support. Indeed, its underlying theory of sexual addiction has been widely repudiated by scientific researchers.

In a scathing new critique in Current Sexual Health Reports, authors David Ley and colleagues challenge the scientific basis for the sexual addiction industry. They argue that the pathologization of visual sexual stimuli (VSS), as they prefer to call it, reflects religious and moral values rather than science.

Chicken or egg?

There is no question that many people are discontented with their use of pornography. About one in 200 Americans reports problematic viewing habits, according to Ley and colleagues’s estimates. The ambiguity is whether pornography is a cause, or a reflection, of life dissatisfaction. Supporting the latter possibility, for example, is a large-scale Dutch study finding that lower life satisfaction predicted greater use of online pornography, not the other way around. Similarly, people with more severe psychological problems and drug and alcohol use are more likely to be heavy viewers of visual sexual stimuli.

It makes sense that people might escape into fantasy not only for sexual release but also to avoid negative mood states such as loneliness. We have only to look to the wave of relationship-phobicsoshoku danshi (literarally, "grass-eating boys") in Japan to technosexuals like Davecat (whose YouTube video has gone viral) who prefer robots or blow-up dolls to "organic partners" to sense the breadth of interpersonal alienation is contemporary culture.

Thus, pornography consumption is perhaps more a symptom than a cause of angst, and targeting it for primary intervention might distract from the deeper issues at play.

Ley and colleagues go further, arguing that a skewed focus on negative effects, such as erectile dysfunction and relationship difficulties, hides potential positive health outcomes of "sexual visual stimuli" consumption. Of relevance to forensic practice, there is some evidence that pornography viewing may reduce risky sexual behaviors, especially among individuals who report high levels of sexual sensation-seeking.

Stigmatizing sexual minorities?

One of the more intriguing topics raised by Ley and colleagues is the religious tenor of many treatment programs and advocates of the addiction paradigm. High religiosity turns out to be one of the strongest predictors of treatment-seeking for sex addiction, suggesting that conflicts over personal values rather than the use itself may be driving dissatisfaction.

Taking this one step further, they argue that the anti-pornography movement serves an ideological function of promoting certain values while suppressing others. Individuals reporting addictive use of visual sexual stimuli tend to be non-heterosexual males with high libidos and high levels of sensation seeking. The sexual addiction model, they claim, is an effort to exert social control over technological expressions of sexuality, suppress marginalized forms of sexuality, and stigmatize sexual minorities.

Intriguing as this argument is, I am disheartened by polemics that minimize the dehumanization and degradation of women, in particular, that are the mainstay of pornography. As revealed by scholars Miranda Horvath, Peter Hegarty and colleagues, the messages about women in British "lads mags" are indistinguishable from the rape-justifying statements made by convicted rapists. It's hard for me to see how this could be harmless, both to viewers and to society at large.

It's ironic to me to see the 12-step style pathologization of individual use ascend parallel to the rapacious lucrative pornography industry. They are two counterbalancing, mutually reinforcing, symbiotic industries – porn and anti-porn, each of them resting on an anemic foundation of hyperbole.

And the few who try to explore the deeper and more nuanced cultural implications of pornography find themselves attacked. I was shocked to hear a couple of years ago about a tenured sociology professor getting suspended for showing a progressive critique, The Price of Pleasure, which delves into the seamy underbelly of the lucrative industry. (My first thought was “Whew! Glad I didn’t get any complaints when I showed that same film in my Sexual Violence course at San Francisco State University a few years ago.”)

Ascendancy of the “sex addiction” model

Lest we forget, Ley and colleagues’ critique is not really new. It used to be pretty well accepted among serious scientists that "sex addiction" was a bogus pop psychology invention, yet another example of the quasi-religious 12-step model being grafted onto every conceivable behavior.

Detractors hail back as far as the late 1990s, when sex therapist Marty Klein, Ph.D. wrote his prophetic essay, "Why ‘Sexual Addiction’ Is Not A Useful Diagnosis -- And Why It Matters," dissecting the politics of this social movement. More recently, Forbes writers Matthew Herper, David Whelan and Robert Langreth tackled "The Shadowy Science Of Sex Addiction." British psychologist and sex educator Petra Boynton followed up with a 2008 critical essay, "Medicalising sexual behaviour" (which includes some good links and discussion of the parallel construction of "female sexual dysfunction”; see my review of Meika Loe's The Rise of Viagra for more on that topic).

The media hype over the sexual peccadillos of golfer Tiger Woods (which had a lot to do with cultural angst over a Black man having lots of sex with white women, blondes no less) proved a huge boon to the fledgling industry.

Also lending an aura of legitimacy was the ill-fated proposal to add "hypersexuality" to the DSM-5. A training announcement for sex offender professionals on "Sexual addiction and compulsivity -- the proposed DSM-5 diagnosis of hypersexuality” mustered a veritable grab-bag of 12-step pseudoscience: Patrick Carnes' "levels of hypersexuality"; the "family of origin of a sex addict" and "co-dependence and the co-addict spouse." (I'm not making this stuff up!) And now there’s even an academic journal with the trendy title Sexual Addiction and Compulsivity.

But unless and until the data comes in to establish sexual addiction as a viable scientific construct, it’s yet another example of an over-eager industry putting the cart before the horse.

You are one of the bravest women have read. You have been able to stand clear of what Chomsky called 'Manufactured Consent', and have dared to take on several Holy Cows of today.
I am deeply deeply heartened.
Thank you.
Mike

From the article: "the dehumanization and degradation of women, in particular, that are the mainstay of pornography"

If you don't even know for sure the extent of pornography use on the Internet, how can you claim to know what is the mainstay of those who consume porn on the Internet? In the old days, the porn industry manufactured and most people got what they got and there were only a few flavors. But now people can seek very specific porn fetishes and types of interactions (including live web camming, etc.)

Frankly, I don't see much of the degradation of women in the porn sources I've checked on the web. But that's perhaps because of MY choices. Which is my point. Today, it's more what people seek, not what they are fed.

Gonzo porn is the most popular porn genre and it's bread and it's butter is degradation and violence against women, including real injuries inflicted on women (vaginal and cervical bruising and anal prolapse for example). In some porn inflicting injury and conjuring visible distress in the woman is the entire purpose. You say you don't see 'much' of it, which indicates that you do see it. It exists and it's widespread, regardless of whether you yourself use it. One clever, new marketing strategy in the industry is supposedly 'feminist' porn. The very reason for the existence of this niche market is because so much of mainstream porn is decidedly un-feminist and woman-hating.

Can you support your assertion with a real study or some kind of statistics or sources?

Gonzo porn that features degrading women is only a sub-part of only one genre of porn. It is not all of "porn", like rape is not all of "sex". What I've seen of the most popular search terms for porn include a whole variety of things, none of which (that I've seen) involve search terms having to do with degrading women.

One source I'm familiar with is a popular pay TV channel related to a well-known men's magazine. Of all the "porn" they have shown on that channel in recent years, I can think of only one show that had anything close to what you might be describing. So that might be about 1% of what that channel has been showing in the last 5 years.

So, by two imprecise measures of my own, I don't come up with anything even remotely close to what you seem to suggesting.

As for clever marketing strategy about feminist porn, not sure if you're saying its cynical or real. There are certainly sites out there that are started by real women who want to present porn in a positive way, having NOTHING to do with the rest of the porn industry.

This idea that having an addiction is a cop out from taking responsibility is wrong.

Any effective 'treatment' programme that I know of emphasises that the addict takes responsibility for the harm his / her behaviour has caused. Central to learning to exit without the object of your addiction is learning that you make the decision and that you always made the decision and that deciding not to 'act out' will not kill you, you can survive without acting out.

A 12 step principle is that 'the problem is in the room' - i.e. no one out there is responsible, you are. You cannot control what others do or say to you but you can choose how you react in response. That is called taking responsibility for your actions.

I'm addicted to porn like I'm addicted to food. I always seem to need it, even after I had it recently. If I don't get it for a long period of time its all I can think about. Once I get it, I'm good for a while but then I start thinking about it again and the craving starts.

At least I don't need a needle like those diabetics with their horrible insulin addictions.

I'm a guy and I find porn boring. Sometimes if somebody sends me a link to something new, I might watch it for a few minutes. But after that, it's all too much the same thing. Besides, why should I watch somebody else have fun? I'd rather have the fun myself.

I find my imagination, not to mention real women, much more interesting. Maybe I just haven't found the right kind of porn that pushes all my buttons yet.

I hear stories all the time about guys addicted to porn, and won't even go to bed with their ready and willing wives. I don't get it. You've got real 3-dimensional "porn" you can have with your wife, and you chose what you can see on a laptop instead? I guess I'm just not understanding the perspective.

Neither deals with sex addiction per se, as I think they both barely pre-date its invention. The first is about the 12-step industry in general, while the second is a critique of the entire self-help industry.

Nothing highlights the decadence of society quite like the extent to which people are now forced to be reliant on whatever resources they can muster up on their own, for things society used to but no longer does for them. The worse conditions get, the more self-help will rain down from above.

I don't care if you call it a compulsion or an addiction or whatever but I know I have had a very out of control relationship with my sexuality since I was 12 and while porn was never the central focus of that relationship it was a catalyst for it at times.

It makes me very angry when people play politics and engage it point scoring arguments about something that causes real ruin and anguish in peoples lives and something which they don't know how to change.

Yes there is an industry springing up about his just as there is an industry and many quacks dealing with drug, alcohol and other substance addictions. The fact that there are quacks and charlatans doesn't make the issue less real for those whose lives are out of control.

Sex is mood altering and the buzz and connection it brings can be just as powerful as any drug to those who use it. Sure it is used to medicate anxiety, loneliness and lots of other things as well - it is still real. And sure changing a person's behaviour means that they have to learn to deal with the anxiety, loneliness or whatever but they also have to learn that they can live without the 'drug', and that is not easy when your life time experience has taught you that if you don't have it you will in a sense 'die'.

I have a very ambivalent attitude to 12 step programmes or indeed anything that advocates a programmatic approach to dealing with the issues facing 'sex addicts' or porn addicts. But equally I cannot stand those who off handedly dismiss them. Be pragmatic, you have got to find what works and what speaks to an individual where they are at a particular time. For some people it will be a 12 step programme.

Thanks to all who are participating in this interesting conversation. A reader alerted me that a few of the links are not working. I am having trouble fixing them here, so in the meantime you can get to them from my professional blog site, where the post is also published:

Dr, Franklin - Since you believe that critical exploration is important, are you willing to carefully read this analysis of David Ley's so-called "review of the literature"?

"The Emperor Has No Clothes: A Fractured Fairytale Posing As A Review" - http://pornstudycritiques.com/wp-admin/post.php?post=286&action=edit

In this "review", Ley, Prause & Finn -

1) Omitted all the studies demonstrating the negative effects of porn use. Yes. you read that correctly.

2) Misrepresented the content of several studies they cited in support of their thesis. This was done by cherry-picking sentences out of context.

3) Cited at least 10 studies that had absolutely nothing to with the associated text. Who proof-read this thing?

4) Clearly believe only opioids can cause addiction - not cocaine, alcohol, or nicotine - and certainly not any behaviors. They are out of step with all addiction researchers and the DSM.

5) Denounced the DSM5 for creating a behavioral addiction category. The same DSM they praised for not including porn addiction.

6) Cited Nicole Prause's "in the press" studies, but refused to cite in the press studies by Cambridge University. Valerie Voon of Cambridge performed the first ever brain scan studies on porn addicts. Voon found all the markers of addiction.

7) Clearly did not understand the role of DeltaFosB in reward or addiction. One of the top researchers on deltafosb said their section of Deltafosb was like a bad Saturday night parody.

8) Ignored several brain studies on Internet addicts, which included porn addiction as one of the internet applications.
9) Cited studies from 1980"s to refute the concepts of behavioral addictions.

10) Omitted the mountain of empirical evidence that demonstrates behavioral addictions involve the same shared set of mechanisms and brain changes which occur in drug addictions.

11) Omitted the 2011 new definition of addiction by the American Society of Addiction Medicine. ASAM sated that all addictions are one condition and that behavioral addictions, including sexual behavior addiction, are every bit as real as drug addiction. Note that ASAM contains Many of the researchers that provide the hard data.

All the above, and so much more, is meticulously documented in the analysis. In addition, citations that refute their claims are also provided, and studies are listed that show the negative effects of porn use. If nothing else, the publication of the Ley review demonstrates that the peer-review system is broken.

Sorry. Here's the right link - "The Emperor Has No Clothes: A Fractured Fairytale Posing As A Review"<?strong?>
http://pornstudycritiques.com/the-emperor-has-no-clothes-a-fractured-fairytale-posing-as-a-review/

Have your read Ley's book? Have you read his blog posts?
Have you read Prause's comments? Or seen her studies?
The word bias doesn't cover it.

Then you read the critique of Ley, Prause, Finn review, and you discover that they left out all negative studies and misrepresented many of the studies they cite to support their thesis.

Here's an entire section were they misrepresented all the studies:

---------------------------------------
In any case, in this section Ley et al. tumble from carelessness to mind-boggling incompetence. Not one of the six studies they cite has anything to do with their statements. To wit:

Studies examining rates of VSS use in nationally representative samples find higher rates of VSS use in both adolescents and adults who identify as other than heterosexual [133], as do studies of clinical samples [143].

- Citation 133 has nothing to do with VSS. It's about transcranial magnetic stimulation and depression. Citation 143 has nothing to do with VSS. It's about monkeys: "Male masturbation in free-ranging Japanese macaques."

Trials of DSM-5 hypersexual disorder criteria found that MSM were more than three times as likely to be in such treatment settings, compared with rates of MSM in comparable substance abuse or mental health facilities [144].

- Citation 144 has nothing to do with the above statement. It's "Sleep deprivation: Effect on sleep stages and EEG power density in man"

Increased use of VSS in these populations may reflect adaptive strategies. MSM may be more likely to seek information and stimuli consistent with their sexual orientation. This may reflect a common component of the ‘coming-out process’ of forming a stable sexual identity [145].

- Citation 145 has nothing to do with above statement. It's "Dieting and binging: a causal analysis"

Studies that examine use of VSS in MSM find that these men overwhelmingly endorse these positive benefits from VSS use [146]

- Citation 146 has nothing to do with men who have sex with men. It is about 12 and 13-year olds. "Sexual risk taking in adolescence: the role of self-regulation and attraction to risk"

Thanks for providing me and my readers with this link to a critique of Ley's article. I will review it as soon as I get a moment. In the meantime, can you please tell me who authored it (and/or why it appears to be anonymous)? That seems a little odd.

for science bloggers, especially neuroscience, to be anonymous. Some of my favorites are anonymous, such as neuroskeptic, neurocritic, and scicurious. Maybe such bloggers want readers to focus on only the content.

I am not a scientist or mental health professional. But you gave me a good chuckle about your rationale for anonymous comment.

Anonymous internet comment, at least in my belief, is not made so that readers "focus on detail". It is about not disclosing the source -- which might advise about motivation that may underlie comment. This is especially likely when there is no chance of government sanction. And, I have not been able to identify an economic sanction that may apply. Perhaps you can educate me on that.

I understand the value of anonymity in some contexts (like politics that can jeopardize employment or self-help support group discussions). But, from what I glean from the detail of your comment, you are a mental health professional who is discrediting another mental health professional's published work.

As a layperson, I think that experts on this forum ought to identify who they are when they seek to discredit an author who has the courage of conviction to publish here.

There is nothing wrong with ideas. And criticism is healthy. But, anonymous criticism, I believe, unduly chills people who have the courage to publish their ideas under their own names.

Too many people here have (or potentially have) ulterior motives for their conclusions. If you critique a writer here as an "expert", I want to know who you are so I can assess (rather than speculate about) what may influence your conclusions.

But I'll answer even though you think we should ignore your comments because you are anonymous.

Whatever happened to the tried and true method of addressing the content? The article is heavily cited and addresses nearly every citation and claim in the Ley review. Sadly, It seems as if both you and the author are unwilling to address the substance.

QUOTE: Too many people here have (or potentially have) ulterior motives for their conclusions.

Everyone is already aware of David Ley's ulterior motive: he wrote The Myth of sex Addiction; authored 20 or more blog posts saying porn addiction does not exist; has been a guest on many TV and radio shows debating against the existence of porn addiction. So we already know what Ley will conclude.

QUOTE: If you critique a writer here as an "expert", I want to know who you are so I can assess (rather than speculate about) what may influence your conclusions.

So you are saying that you want to make up your opinion on the content before reading the article? Again, the post takes every Ley citation and every claim and exposes the actual science, backed up with citations.

Maybe you can be brave and daring and read the article and follow the citations - and fearfully arrive at your own conclusion based on the evidence. Or you can have someone tell you what to believe and blindly accept it. Your choice.

First, thank you for replying to my comment. I raised it not only with respect to your specific post or you personally, but to address the "shadow war" that seems to be being fought in the professional debate over this question. Admittedly, I tend to notice it more on the pro-"porn" addiction side since my current opinion is and my experience suggests to me that the likelihood of "porn" being an addiction (similar to an addiction to, for example, opiates) likely is over-stated.

Next, with regard to your suggestion that my response somehow was offensive/inappropriate/illogical because I only use my first name and initial of my last name on PT -- I'll show you mine if you show me yours?

In further answer to your pithy critique, under my analysis, my anonymity is not important since I do not hold myself out as an expert in addiction, psychology or pornography -- although I have amassed some experience with all three (the first as an observer and the other two as a consumer).

The justification for my anonymity is based on me sharing personal-life anecdotal information as the basis for my admittedly not-statistically or study substantiated personal opinions. They are identified as personal opinions, based only on personal life experience, inference and observation.

Stated another way, what I say has little value in the "proof" portion of this debate because I don't claim to be bringing "proof" to the table. This, in my view, is not inappropriate since these forums, as I understand them, are not reserved exclusively for learned comment. My comments largely are written in lag-time between work tasks. (I know, it shows, doesn't it?)

Your response suggests that you do claim to speak as an expert. (It, for example, suggests that you have significant expertise and you have applied enough care and attention to this area to have identified and assembled links to many articles and studies that you declare refute Mr. Ley's position, demonstrate its predictability and bias, and discredit his science.) It is this thoroughness that suggests to me that you are an expert or are holding yourself out as an expert. (If you will not accept that flattery of expert status, we can, for the limited purpose of this comment, refer to you as an "enthusiast" or, possibly, an industry "usual suspect".)

I questioned your anonymity only because you have not based your argument (like another pro-porn addiction "anonymous" here whose comment and anonymous status I have not questioned), on your personal struggles or observations of friends' or family members' struggles with "porn" addiction. Instead, your comment suggests that you bring a different, "higher" level of analysis to the discussion.

I really don't care whether I convince you, or anyone else here, with my comments/arguments. Many of my comments, like yours, are made in an effort to suggest that what is claimed to be settled, might not be all that settled.

By trade, I am a lawyer. Part of analyzing expert testimony (and trying to assess whether that testimony is believable and/or will influence the finder of fact) involves understanding what may have influenced the opinions of both the expert and the audience. (I generally explain that with the aphorism "where you stand has a lot to do with where you sit".)

(As an aside, we "untrustworthy" lawyers have a professional duty to disclose to courts controlling authority contrary to our clients' positions. Not doing so is considered "fraud on the court". While PT is not a court, a similar duty of even-handed candor does not seem to be applicable to this debate on "porn" addiction.)

I am not fearful of reaching conclusions that conflict with my beliefs. And I will read your cited materials. (A part of my practice deals with health care so I have some limited familiarity with reading studies.)

I don't adhere to what Mr. Ley states as writ. I don't expect I will blindly agree with what you or your citations assert. My more than typical agnosticism derives from the fact social science studies only can show association not causation. (The prospect of a double-blind placebo controlled study of partner sex functionality and pornography use does intrigue me though. Is it in the recruitment phase?) In my ignorance, I believe that the interpretation of study associations should be filtered through experience of the reader.

But, I will (bravely, like the storied trailer) read them despite your, presumably principled, stand on maintaining your anonymity while you eviscerate/attempt to eviscerate Mr. Ley's arguments/scholarship. Perhaps more people would read them if they knew your identity?]

See how this whole discussion has purposely degraded into spinning what was said and who said it, rather than the content of Ley's article, and the subsequent analysis of it.

I am not the author of the analysis. I posted one link, which has been widely circulated.

My little pithy comment was employed to highlight the absurdity of your argument that one must not address content unless everything about the author is revealed. For the 4th time, all the evidence has been laid out and thoroughly documented...for all to see. Including you.

Nothing else in your comment relates to the analysis. Are you willing to discuss the topic at hand, or not?

Godwin's law (or Godwin's Rule of Nazi Analogies)[1][2] is an Internet adage asserting that "As an online discussion grows longer, the probability of a comparison involving Nazis or Hitler approaches 1" —​ that is, if an online discussion (regardless of topic or scope) goes on long enough, sooner or later someone will compare someone or something to Hitler or Nazism.

Another anonymous comment, on an anonymous comment, on a comment thread that was derailed by an anonymous user whose argument was anonymous comments are not the best additions to a argument. Ohhhh the irony

Hey John B - Where did you get the idea that poster "second opinion" was the one who authored the critique of the Ley "review"?

You said - "Your response suggests that you do claim to speak as an expert. (It, for example, suggests that you have significant expertise and you have applied enough care and attention to this area to have identified and assembled links to many articles"

Are you saying if anyone posts a link, and gives main points that the link covers you assume they authored it? Only one link was posted, and I do not have the expertise in analyzing that you have being a lawyer and all, but I did not see any reason to assume what you have.

Now to this... You said - "I questioned your anonymity only because you have not based your argument"

The link is an analysis of the "review" that this blog post is centered around. There IS NO ARGUMENT. It is based on facts, not opinions, of how the "review" either knowingly, or unknowingly did not include what it claimed to include, and misrepresented a lot of it's findings. If you read the analysis you will see for yourself.

You said - "I really don't care whether I convince you"

Convince them of what? His post pointed out flaws, and misrepresentation of the truth. What is there to convince them of? They never even said if they were for porn addiction or against porn addiction......

@ Karen - That post was not an argument. It was for you to actually critically explore the review you just based your whole blog post on. It is not an opinion based analysis.... you might.... just miiiight want to check it out.

My comment (as you clearly know) originally involved second opinion's defense of anonymous comment by experts in the PT comment section. More specifically, I asserted that experts who post comments here ought to identify themselves so that lay people can evaluate the perspective they bring to specialized knowledge that they assert that they have.

"They never even said if they were for porn addiction or against porn addiction."

Exactly my point.

After that, things got chippy between second opinion and me. I could explain myself more fully, but no longer want to set myself up for second opinion's (who you defend) entertainment.

You quote me above:

"'Your response suggests that you do claim to speak as an expert. (It, for example, suggests that you have significant expertise and you have applied enough care and attention to this area to have identified and assembled links to many articles.

Are you saying if anyone posts a link, and gives main points that the link covers you assume they authored it?"

This portion of my comment was poorly written (I mistakenly credited second opinion with authorship of your post and mistakenly indicated that there was more than one link). But, you understood the nature of my mistake all along, of course.

"'I questioned your anonymity only because you have not based your argument'.

The link is an analysis of the "review" that this blog post is centered around. There IS NO ARGUMENT"

My language was addressed to and relates to my belief that anonymous comment by experts is not helpful while anonymous lay person comment should be subject to a different standard. You cherry picked the quote (presumably with the purpose of distorting it - quite common in my business too by the unscrupulous).

"You said - [']I really don't care whether I convince you[']

Convince them of what? His post pointed out flaws, and misrepresentation of the truth. What is there to convince them of?"

This language from my comment too (as you know) was directed at the difference between expert comment citing specialized knowledge and layperson comment citing only personal experience. You, again, cherry pick and take the language out of context to discredit and distort.

"There IS NO ARGUMENT. It is based on facts, not opinions, of how the "review" either knowingly, or unknowingly did not include what it claimed to include, and misrepresented a lot of it's findings."

Experts on both sides of conflicting recent reviews on HRT said much the same thing. Both camps, there, cannot be right. Perhaps the same righteous division is present here, too? I don't know if that is true, but that is why I want to know where the proponents stand. Review too often it seems to me tend to bleed over into advocacy.

I have learned to be highly cautious about identifying something as "truth" which presumably means more than "technical truth". Most of what is characterized as "truth" requires a looser than literal interpretation of what I understand the to be "truth's" definition.

I don't intend to further cut and paste quotes from today's or yesterday's posts (yours, second opinion's or mine). I will leave to you and second opinion this "joy" and will leave to others their assessment of my comments and those of you and second opinion.

I don't apologize for wanting to know "where you stand" before I read a review of Ley's work.

Addressing now my understanding of the science claimed to support "porn addiction" which is not based on Dr. Ley or his review, my concerns lie with breadth of conclusions that some have asserted based on this science. These concerns implicate both public policy generally and medical claims policy issues.

This debate is just one part of tangles that concerns me -- what is appropriate covered mental health treatment under applicable law and whether particular outcomes for some people provide justification for censorship or regulation.

Because you have identified (properly) that some of my writing was disjointed and incomplete, I apologize to you (not second opinion) for my lack of clarity yesterday (and to all for my verbal incontinence). I try not to write like that because I well understand that "poisoned arrows" can come from persons other than mythical Cupid.

Nothing absurd about my comment. Looking at articles and studies is not more virtuous or informative if you do it before you understand the proponents' affiliation. I suppose that is why the FDA requires people who perform studies to contemporaneously disclose their affiliations. The FDA is not afraid that its review of studies will be prejudiced if it knows the affiliations before it reviews the studies. But, of course, the players in this debate are principled and special.

What is absurd is a bunch of financially interested "experts" arguing about a social science conclusion that stands to enrich them significantly without disclosing their identities or affiliations.

Perhaps you are right about the science (although your reluctance to identify yourself makes me question that). But this anonymous debate stinks to high heaven to this onlooker.

What also would stink to this onlooker would be a coordinated effort to anonymously stifle and discredit critics with plausible positions. Kind of smacks of the "c-word" to me. This anonymous effort appears to me to be coming largely from the "pro-addiction" side of the debate. If you are right, discrediting junk science would enhance your reputations. So why be bashful?

I can think of several sources that would fund outcome driven pro-addiction research to enhance their social policy positions (leaving aside the money to be made) -- the religious right coming immediately to mind. Porn has money (which may influence the anti-addiction point of view), but it lacks the influence, structure and message discipline of the religious right. Imagine the negative perception that an organized porn lobby would create.

I have sufficiently raised my concerns to no longer have to deal with your pit-bull in the dark tactics.

So, go on out there and sell some books and scare people into a return to repression. And, go console yourselves with your financial projections and dream about the money to be made if you can spawn this as an industry.

All of the above may be untrue of course -- but I have no way of knowing that when these responses are uncivil and anonymous, do I?

Very well put. You don't need to be a scientist or a mental health professional to realize that one aspect of a full analysis of an argument is consideration of the proponent, and any potential conflicts, motivations, biases, etc. It is basic common sense to recognize that nothing and no one is entirely neutral and value-free. For example, a critical piece of exposing the massive influence of Big Pharma and the tobacco industry on their respective research areas was to follow the money trail. More related to pornography and sex addiction, much neuroscience research is heavily influenced by the biomedical model and its underlying values and biases about the nature of human behavior, motivation, etc. Unfortunately, a full exploration and analysis is precluded when someone hides behind a shield of anonymity. It definitely makes one wonder.

QUOTE FROM ARTICLE: Lest we forget, Ley and colleagues’ critique is not really new. It used to be pretty well accepted among serious scientists that "sex addiction" was a bogus pop psychology invention, yet another example of the quasi-religious 12-step model being grafted onto every conceivable behavior.

You then cite a few articles about sex addiction - not Internet porn addiction. Huh?

The first "expert" you cite is Marty Klein, who received his PhD from an unaccredited school, and has no back ground in neuroscience. The other two links are not neuroscientists.

What about quoting addiction neuroscientists as saying the porn addiction is bogus?

- Maybe Nora Volkow head of NIDA? Sorry, she wanted to change the name of NIDA to include porn addiction.

- What Eric Nestler, probably the top researcher into addiction mechanisms in the world? Nope, he states on his lab's webpage that sex addiction exists.

- What about the MD's and researchers who are members of the American Society for Addiction Medicine? No way, the organization stated that sexual behavior addiction exists. From The ASAM faqs. http://www.asam.org/advocacy/find-a-policy-statement/view-policy-statement/public-policy-statements/2011/12/15/the-definition-of-addiction

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QUESTION: This new definition of addiction refers to addiction involving gambling, food, and sexual behaviours. Does ASAM really believe that food and sex are addicting?

ANSWER: The new ASAM definition makes a departure from equating addiction with just substance dependence, by describing how addiction is also related to behaviors that are rewarding. ... This definition says that addiction is about functioning and brain circuitry and how the structure and function of the brains of persons with addiction differ from the structure and function of the brains of persons who do not have addiction. ... Food and sexual behaviors and gambling behaviors can be associated with the "pathological pursuit of rewards" described in this new definition of addiction
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I guess ASAM members, which include Volkow & Nestler, must not serious scientists like Ley and Klein?

First of all... Ley and his team use nothing but straw man points for their arguments. As I am sure you know, a straw man argument requires that the audience be ignorant or uninformed of what the argument actually is about.

The topic of porn addiction is about it's effect on the brain. You know, because that is where addiction takes place and all.

Ley and his "team" try and focus on everything except the brain, and when they do actually bring the brain into it... they make a giant mess out of the neuroscience, or twist the facts around until something fits their agenda. As you will see if you read these critiques of Ley and his buddy Prause:

And the one that points out how misleading the Ley review was, that user secondopinion suggested you read. If you truly are interested in critical exploration of the topic of porn addiction I highly recommend these.

Now, back to the straw man rubbish that does not match the reality of the argument, and is meant to throw dust up in the air to get the focus off reality (the reward circuit in the brain). First and foremost, they use the term sex addiction as if it is the same thing as porn addiction, but I won't even go there.

Here are a few of them that you covered in this blog post. Porn addiction reflects "religious and moral values" (this one includes use driven by shame and guilt), a reflection of "life dissatisfaction", severe "drug and alcohol use", avoiding negative mood states "such as loneliness", tends to be about individuals who "are non-heterosexuals with high libidos"....

Then they try and put the focus on "the lucrative industry" as if that has ANYTHING to do with whether or not chronically watching internet porn has the ability to cause addiction related brain changes. Yea... it doesn't. Plus, I and many other porn addicts are recovering by learning and using a neuroplasticity approach, and are not spending a single penny on recovery just for the record.

What do a majority of porn addicts and guys with porn induced sexual dysfunctions really look like? Let's take a look so I can show you how the straw man dust hides the truth.

Religion- The majority of members on porn addiction recovery forums are athiest or agnostic and openly say they had no shame in their porn use, and they only gave up porn when they found it was having a negative physiological impact on them, like a limp penis... to them and I porn was not a "moral" issue, it was a "my penis stopped working issue". Obviously it is a moral issue for some, as it is with any addiction- but addiction is about very specific brain changes not morals. One would have to be up to date with the latest addiction neuroscience to understand this.

Gay- Well this one is easy, I am not gay and the vast majority of the members on secular porn recovery forums are not gay either...mostly young healthy heterosexual males who over years of internet porn use developed sexual dysfunctions such as delayed ejaculation, or erectile dysfunction. All of these straight men recovered by giving up porn and once again could get it up with their women, including me.... However some gay men also recover from the same dysfunctions when removing porn use.... moving along

High Libido- If this were true, then guys would be able to masturbate without porn. However, I and others who developed porn-induced ED can NOT masturbate without porn. It took me 9 months to be able to get an erection without porn. Lets be clear...that is not a "high libido"

Sucky life(Dissatisfaction)- I thought my life was awesome before I developed ED at the ripe age of 23. Many guys on the forums did not have "issues" that drove them to use porn. They simply had "access" at a young age to high-speed internet porn like I and 4 other of friends did who all developed porn related dysfunctions and recovered simply by giving up porn.

Shame- See "religion" point above... I had no shame and thought porn was awesome... I am a heterosexual male who likes naked girls. Ground breaking science right there.

You would think if they wanted to come out with an honest and unbiased "review of the literature", they wouldn't have asked the author of The Myth Of Sex Addiction, who has blogged and said for years porn addiction and porn induced sexual dysfunctions do not exist.

First, the Ley review refused to consider any studies that found negative effects. That's right.

Second, they misrepresent the content and conclusions of the studies they cite in support of their thesis. Let's start with the first section of their review. Everything is cited in the review:

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Next our audacious authors claim that most scientists have overtly rejected the addiction model [3, 4]. This is untrue, and neither of their citations remotely supports the claim that "most" scientists have "overtly rejected" the addiction model for sexual behavior addictions. Nor does either citation relate to research by addiction neuroscientists, who have publicly concluded the opposite.

Eric Nestler PhD, head of Nestler Lab (Molecular Psychiatry) at Mount Sinai's Icahn School of Medicine writes about addiction:

It is likely that similar brain changes occur in other pathological conditions which involve the excessive consumption of natural rewards, conditions such as pathological over-eating, pathological gambling, sex addictions, and so on.

From ASAM's press release:

CHEVY CHASE, MD, August 15, 2011 – The American Society of Addiction Medicine (ASAM) has released a new definition of addiction highlighting that addiction is a chronic brain disorder and not simply a behavioral problem involving too much alcohol, drugs, gambling or sex.

Citation 3 is from 2000. "Sexual disorders not otherwise specified: compulsive, addictive, or impulsive?" It basically says that the DSM should include diagnostic criteria for the disorder underlying the various labels:

Excerpt: Growing evidence supports the existence of a discrete syndrome characterized by recurrent and intense sexually arousing fantasies, sexual urges, or behaviors involving patterns that fall outside the definition of paraphilia. We suggest that the DSM-IV category of sexual disorders be modified to include explicitly diagnostic criteria for a disorder characterized by hypersexual symptoms.

Citation 4 in no way rejects the notion of sex addiction. ("Should Hypersexual Disorder [HD] be Classified as an Addiction?") In fact, it says that "available data suggest that considering HD within an addiction framework maybe appropriate and helpful." (emphasis added) In short, the reality is the opposite of "overtly rejecting" the addiction model, the proposition for which Ley et al. cited these items.

Excerpts: A number of clinical elements, such as the frequent preoccupation with this type of behavior, the time spent in sexual activities, the continuation of this behavior despite its negative consequences, the repeated and unsuccessful efforts made to reduce the behavior, are in favor of an addictive disorder. ...

The phenomenology of excessive nonparaphilic sexual disorder favors its conceptualization as an addictive behavior, rather than an obsessive-compulsive, or an impulse control disorder.
--------------

So Ley, Prause and Finn started off by completely misrepresenting the studies, and have no backing for their claim. In fact, their citations refute their claim - how dishonest is that?

... if sex/porn can't be an addiction, would this not mean that gambling too would be a 'mere symptom' of something else, perhaps even a moral dilemma?

Yes, there are snake-oil sites for pornography addiction ranging from the pseudo-scientific to the religious to some that have roots in radical feminists of the anti-porn variety. (Porn use and prostitution are very divisive subjects within feminism and result in much infighting between feminist factions.

But there are also well educated mental-health professionals writing studies and reports (and citing their references) who also happen to be radical feminists or right-wing religious zealots.

If anything, the only 'reference' I need is to find out what their actual agenda is. Feminists and right-wing religious nuts need not apply. I can tell you their conclusions before they put pen to paper, regardless of the validity of their sources. They all conclude that porn and the personal and societal problems with it are caused by misogyny, narcissism or sin and have no similarities to other "real" addictions like stimulants (including nicotine and caffeine) and, depressants (including alcohol).

Following this logic we could say that all addictive and compulsive behavior is the result of a moral deficiency or character flaw or at best the side-effect of one or more personality disorders. Sure there is co-morbidity between addictions and certain mental health problems - there is also corollary with socio-economic status and education level. But this would not explain why people who are not poor, uneducated or diagnosed with a specific personality disorder are addicts. The popular meme of the addict is they had a dysfunctional family growing up wife with abuse or neglect - but the reality is that good kids from good homes also get wrapped up in substance abuse. It also does not explain why moral church-going people get in trouble with drugs, alcohol, gambling or pornography, but the "not an addiction" camp would likely say they are just doing (religion) wrong.

So, all that said, I don't think it's of primary importance to differentiate between these various damaging behaviors to the extent that these pundits and experts say, and I also question their motivations for doing so. The slippery slope there is that "chemically dependent" addicts get therapy and medication and "compulsive behavior" addicts get prescribed prayer and spiritual awakenings.

In my city, they want to give chronic alcoholics a drink every 90 minutes to keep them safer and off the streets looking for booze and using more dangerous chemicals including solvents, perfumes and cleaning agents. This, while professionally employed people who want to (responsibly) enjoy a marijuana cigarette on the weekend cannot legally obtain this drug because of it's alleged damage to society.

Until we finally mature out of the age of the demon and the witch, we will continue to thwart research and development of treatment for various addictions that are looked upon by society (and by extension, some professionals) as moral problems or "mere compulsions". It's also interesting that a person with a compulsion to count cracks in the sidewalk to alleviate anxiety is pitied and "treated" while a person who looks at porn compulsive for the same reason is vilified and needs a "spiritual cleansing" or is just cast off as a narcissist or misogynist.

That same person is posting the same link on, like, every news story that even starts to be critical of sex addiction. I think Gary Wilson and Marnia Robinson might be addicted to blogs and conspiracy theories! (Those are the owners of the mysterious website linked.)

I feel terrible for the PT writer whose comments got hijacked by these cases.

"That same person is posting the same link on, like, every news story that even starts to be critical of sex addiction."

Well... you mean all the stories critical of sex addiction EXCEPT David Ley's? Because he turned off comments on some of his articles.

The only thing "crazy" (and funny to me) is Ley or Prause still have not addressed the content in the analysis of his "review". Just like absolutely no one in this comment section has addressed it. Just like any one on any of those other stories you're talking... no one will address the fact that Ley manipulated his findings, or unknowingly did not include stuff that he should have.

Also, "Anonymous", I will ask you the same thing I asked John B, what about previous posts on this thread, made you assume who the author of that link is?

The analysis of David's review has been circulated far and wide. Literally hundreds of thousands of people have seen it, along with the other 2 critiques I posted that, again, no one has addressed the content of.

My comments (and second opinions, and Eric Moores, and anonymous...) are directed directly at the content of Karen Franklin's blog and the Ley "review" it was based on. The only hijacking going on is by posters who refuse to address my points.

So, anyone up to actually address our content. I, and others following this conversation would appreciate it.

You are so very young. I know you will not be able to hear this now, but consider that you might not want your sex life posted all over the Internet in 10 years. Whatever you want to change about your own sexual behavior you absolutely have the right to do, and I wish you luck, but I am very worried about someone your age being used by the machine. A little time, a little humbleness, and little curiosity...things might look very different looking back in time with the perspective of experience.

Just please be careful. I hate to see more people get hurt by that crowd.

Thanks for the words of concern. However, I feel pretty confident that many years from now (hopefully), lying on my death bed, I won't regret being honest in order to help others.

"Just please be careful. I hate to see more people get hurt by that crowd."

Are you saying that, suggesting a young man with unexplained ED, who checks out fine with the doc, give up porn and see what happens, could possibly hurt someone? If so, please explain.

Or, are you suggesting I will regret sharing what fixed my ED with other young healthy men and teenagers with the same problem, some who are now suicidal and need hope because all the info they have received thus far hasn't helped?

"but I am very worried about someone your age being used by the machine"

And I am very worried about young children and teens, whose brains are most vulnerable to addiction, using their machines for internet porn, and ending up in Limp Noodle Town.

As someone who has never been addicted to pornography, and can't personally understand how one could even be addicted to it, I'd like to understand how an image or video of something could be more interesting than the same thing in reality. And how could mere images reach the level of addiction, and the same thing in reality not be interesting? Obviously I'm missing the perspective, or something.

And to the guy who could not get an erection without porn? Are you saying you can't get an erection if you had the same thing in reality that you see in the porn? What am I missing?

It seems kind of funny to me, like somebody preferring pictures of dollar bills instead of actual dollar bills! Heck, there's a business opportunity. Don't mean to make light of it too much, but as a guy, if the rest of you guys out there could all please be addicted to porn, I'd have a lot of women to have fun with! And I guess I'd be one of the few guys available to star in porn with all the available women, just so you addicts could watch me have fun!

But perhaps from that humorous viewpoint, you can see why I don't "get" what's so interesting about porn.

The following is taken from the ED section of the Ley analysis. Note that links are provided within the analysis.

------------------------

Ley et al. admit that two European studies have found a startling increase in ED in young men. However, neither belongs in "No Clothes." The researchers in those studies didn't think to poll their subjects about internet porn use. They could only theorize that the increases in youthful ED might be stemming from factors such as smoking, drug use, depression or poor health. As an aside, smoking is at an historic low, and it only causes ED problems in longtime smokers who develop arterial disease. Commenting about these two studies, urologist James Elist said that Internet porn was the primary cause of ED in young men:

recreational drugs, smoking, and mental health seem, compared to internet porn consumption, to be making up rather the smaller portion of elements being responsible for early onset ED.

Next Ley et al. hypothesize that porn can't cause ED because the brains of men with and without ED showed no differences during VSS viewing in (63). Actually citation 63 is irrelevant to the discussion of ED and porn. It only examined cerebral cortex activity, not the limbic regions that govern desire and erections. Incidentally, Ley et al. ignored another study that did find differences in cerebral activation between those with psychogenic ED and controls: "The role of left superior parietal lobe in male sexual behavior: dynamics of distinct components revealed by FMRI."

Note: 'Psychogenic ED' is a term for ED, such as porn-related ED, which cannot be explained by organic causes such as vascular damage.

Ley et al. (and their reviewers) apparently overlooked the next two studies as well, which revealed significant differences (in the limbic brain regions that control sexual excitement and erections) when researchers compared control subjects with subjects who had psychogenic ED.

In their determination to dismiss internet porn as a possible cause of unprecedented youthful ED, Ley et al. even vilify masturbation and orgasm. (The irony of this position taken by the champions of "high sexual desire" is noteworthy.) They prefer to theorize about these two time-honored, normal activities, rather than consider the glaring possibility that high-speed internet porn, a brand new stimulus that has only been present for the blink of an eye in evolutionary terms, might be a factor.

They reach the remarkable conclusion, supported by no urologist, that chronic ED in young men is a function of masturbation, or, alternatively, the refractory period. The latter is particularly droll in light of the fact that it sometimes takes 2-12 months for guys to get their erections back even after quitting porn/masturbation. That's some refractory period!

Persistent porn-induced ED in young men caught the medical profession by surprise, but this year doctors have finally begun to acknowledge it. Harvard urology professor and author of books on men's health Abraham Morgentaler, MD said,

"It's hard to know exactly how many young men are suffering from porn-induced ED. But it's clear that this is a new phenomenon, and it's not rare."

And Cornell urology professor and author Harry Fisch, MD writes bluntly that porn is killing sex. In his book The New Naked, he zeroes in on the decisive element - the internet:

It "provided ultra-easy access to something that is fine as an occasional treat but hell for your [sexual] health on a daily basis.

Dr. Fisch continues:

I can tell how much porn a man watches as soon as he starts talking candidly about any sexual dysfunction he has. ... A man who masturbates frequently can soon develop erection problems when he's with his partner. Add porn to the mix, and he can become unable to have sex. ...

"Porn is something that is supposed to stimulate and arouse men (or women) sexually can actually destroy their overall libido and performance. So why isn't anyone talking about the effect on sexual performance ...? Probably because they flunked sex ed for grownups. They're discussing why a guy watches it--and not what happens to his penis when he watches."